Prevalence of Emergency Department Social Risk and Social Needs.
Prevalence of Emergency Department Social Risk and Social Needs.
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DOI：
10.5811/westjem.2020.7.47796
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发表时间：
2020-10-06
期刊：
影响因子：
--
通讯作者：
Samuels-Kalow M
中科院分区：
文献类型：
--
作者：
Molina MF;Li CN;Manchanda EC;White B;Faridi MK;Espinola JA;Ashworth H;Ciccolo G;Camargo CA Jr;Samuels-Kalow M
社会风险，或与健康状况不佳相关的不利社会条件，在急诊科（ED）患者中普遍存在，但关于社会风险的普遍程度与患者报告的社会需求（其中包括患者对干预的偏好）之间的比较，我们知之甚少。本研究的目的是描述社会风险和社会需求之间的关系，并确定对社会风险和社会需求问题的不同反应的相关因素。我们在一个大型城市急诊科进行了48小时时移抽样的横断面研究。同意的患者完成了一份人口调查问卷，并评估了社会风险和社会需求。我们应用描述性统计分析社会风险和社会需求的流行程度，并使用多变量逻辑回归来评估与社会风险、社会需求或两者相关的因素。在269名参与者中，100人（37%）报告了社会风险，83人（31%）报告了社会需求，169人（63%）既没有报告社会风险也没有报告社会需求。社会风险与社会需求虽有显著相关（p < 0.01），但不完全重合。每个类别中超过50%的人在一个以上领域（如住房不稳定、粮食不安全）中筛查呈阳性。在多变量模型中，受过高等教育（调整比值比[aOR] 0.44[95%置信区间{CI}， 0.24-0.80]）和私人保险（aOR 0.50 [95% CI, 0.29-0.88]）的人报告社会风险的可能性分别低于受教育程度较低和国家/公共保险的人。西班牙语患者（aOR 4.07 [95% CI, 1.17-14.10]）和非西班牙裔黑人患者（aOR 5.00 [95% CI, 1.91-13.12]）更可能报告社会需求，而拥有私人保险的患者更不可能报告社会需求（私人与国家/公共：aOR 0.13 [95% CI, 0.07-0.26]）。在大型城市急诊科，大约三分之一的患者至少有一种社会风险或社会需求筛查呈阳性，每个类别中超过一半的患者报告了多个领域的风险/需求。不同的人口统计变量与社会风险和社会需求相关，这表明有社会风险的个体与有社会需求的个体不同，筛查项目应该考虑包括这两种评估。
Social risks, or adverse social conditions associated with poor health, are prevalent in emergency department (ED) patients, but little is known about how the prevalence of social risk compares to a patient’s reported social need, which incorporates patient preference for intervention. The goal of this study was to describe the relationship between social risk and social need, and identify factors associated with differential responses to social risk and social need questions. We conducted a cross-sectional study with 48 hours of time-shift sampling in a large urban ED. Consenting patients completed a demographic questionnaire and assessments of social risk and social need. We applied descriptive statistics to the prevalence of social risk and social need, and multivariable logistic regression to assess factors associated with social risk, social need, or both. Of the 269 participants, 100 (37%) reported social risk, 83 (31%) reported social need, and 169 (63%) reported neither social risk nor social need. Although social risk and social need were significantly associated (p < 0.01), they incompletely overlapped. Over 50% in each category screened positive in more than one domain (eg, housing instability, food insecurity). In multivariable models, those with higher education (adjusted odds ratio [aOR] 0.44 [95% confidence interval {CI}, 0.24–0.80]) and private insurance (aOR 0.50 [95% CI, 0.29–0.88]) were less likely to report social risk compared to those with lower education and state/public insurance, respectively. Spanish-speakers (aOR 4.07 [95% CI, 1.17–14.10]) and non-Hispanic Black patients (aOR 5.00 [95% CI, 1.91–13.12]) were more likely to report social need, while those with private insurance were less likely to report social need (private vs state/public: aOR 0.13 [95% CI, 0.07–0.26]). Approximately one-third of patients in a large, urban ED screened positive for at least one social risk or social need, with over half in each category reporting risk/need across multiple domains. Different demographic variables were associated with social risk vs social need, suggesting that individuals with social risks differ from those with social needs, and that screening programs should consider including both assessments.
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DOI：
10.1001/jama.2016.4226
发表时间：
2016-04-26
期刊：
JAMA
影响因子：
--
作者：
Chetty R;Stepner M;Abraham S;Lin S;Scuderi B;Turner N;Bergeron A;Cutler D
通讯作者：
Cutler D
影响因子：
4.4
作者：
James, Thea L.;Bibi, Salma;Mitchell, Patricia M.
通讯作者：
Mitchell, Patricia M.
DOI：
10.1525/jer.2007.2.4.69
发表时间：
2007-12-01
影响因子：
1.3
作者：
Breese, Peter E.;Burman, William J.;Weis, Stephen E.
通讯作者：
Weis, Stephen E.
影响因子：
5.4
作者：
Berkowitz, Seth A.;Hulberg, A. Catherine;Atlas, Steven J.
通讯作者：
Atlas, Steven J.
影响因子：
3
作者：
Basu S;Berkowitz SA;Seligman H
通讯作者：
Seligman H